medicare facts and figures: a california perspective€¦ · enrollment in medicare california and...

February 2006

Medicare facts and figuresA California Perspective

©2006 California HealthCare Foundation 1

California has the largest number of Medicare

beneficiaries of any state — over 4 million enroll-

ees — and as the population ages, the percentage

of Californians with Medicare will continue to rise.

California’s entire elderly population, those 65

and over, will grow nearly 130 percent by 2030.

The increase is especially striking among those

85 years and over. Across California’s counties,

the growth of this population has ranged from

33 percent to over 150 percent since 1990.

The diversity of coming Medicare populations

will also increase in the next decades and,

accordingly, the number that speak non-English

languages will likely continue to grow.

Overall, Medicare spending continues to

rise, with approximately 10 percent of all

current Medicare expenditures occurring in

California. California’s spending per beneficiary

is also higher than the national average — about

$700 more per beneficiary per year — the eighth

highest in the nation.

This profile provides a factual framework

to help consumer advocates, health care pro-

viders, and policymakers better understand

California’s Medicare population and inform

their efforts to design programs and policies that

meet Medicare beneficiaries’ needs. Data are

drawn from the most recent national and state-

level sources available. Some of these charts

rely on data from a sub-sample of the 2002

Medicare Current Beneficiary Survey (MCBS)

in California. The MCBS is a stratified random

sample of beneficiaries representing the entire

population of aged and disabled beneficiaries

and is not necessarily representative of each

state. The MCBS sample for California includes

1,049 residents. Where possible, results were

confirmed by comparison with Census records,

the California Health Interview Survey, CMS,

and Social Security statistics.

Introduction

There are more than

4 million Medicare

beneficiaries in California

and those numbers will

continue to grow as the

baby boomers age.

Medicare Introduction


Population Growth Rates Elderly vs. Non-elderly California and the U.S., 2000 to 2030

Projections of population

growth in California show

that the elderly population

will grow much faster than

the non-elderly population

over the next 25 years due

to the aging of the baby

boomers.

Elderly (65+)

Non-elderly(< 65)

19%

26%

104%

131%

U.S.California

Note: The under-65 population in the nation is expected to grow by 45.7 million by 2030, including growth of 7.9 million in California. The national elderly population is expected to grow by 36.5 million over the same period, with 4.7 million of this growth occurring in California.

Source: “Table 4: Interim Projections: Change in Total Population and Population 65 and Older, by State: 2000 to 2030.” U.S. Census Bureau, Population Division, Interim State Population Projections, 2005.

Medicare Overview


Enrollment in Medicare California and Selected States

Medicare Overview

There are 40.2 million

Americans enrolled in

Medicare in the United

States. California has the

largest number of Medicare

beneficiaries in the nation

at 4.1 million, but ranks

much lower — 46th in the

nation — as a share of the

total population.

0

5,000,000

10,000,000

15,000,000

20,000,000

25,000,000

30,000,000

35,000,000

PennsylvaniaFloridaNew YorkTexasCalifornia

Enrollment as Share of Total PopulationNon-Medicare Population12%

11%

14%

17%

17%

Total Population

Note: Enrollment for California is 4,078,426; Texas 2,390,053; New York 2,763,299; Florida 2,920,971; and Pennsylvania, 2,110,470.

Source: Centers for Medicare and Medicaid Services, Medicare Enrollment Data for July 2003 and Census Bureau State Population Estimates 2000–2005 (NST-EST2005-01).


Eligibility for Medicare California, 2002

The majority of Medicare

beneficiaries in the state

are over 65. Eleven percent

are eligible due to disability

status, and a smaller

percentage have end-stage

renal disease (ESRD).

Note: One-third of enrollees with ESRD are disabled and another one-third are 65 or older. The remaining one-third is not otherwise eligible for Medicare. These enrollees are all included in the ESRD section above.

Source: 2002 Medicare Current Beneficiary Survey.

Elderly87%

ESRD

2%

Disabled11%

Medicare Overview


Elderly Population Growth by County, 1990 to 2004

Source: Calculated from both the 1990 and 2000 Census data. The 1990 data is available in archived population estimates (www.census.gov/popest/archives/1990s/co-99-13/cacamars.txt). The 2004 data is a projection from the 2000 Census in the file “County estimates by demographic characteristics — age, sex, race, and Hispanic Origin: Selected Age Groups and Sex“ (www.census.gov/popest/datasets.html). See appendix for more information on growth rates by county.

Every county in California

has experienced significant

growth in the elderly

population in the last

15 years. Even more

dramatic is the growth

among those 85 and older,

with a median growth rate

of 87 percent.

Median and Below (21%)

Above Median

Age 65 to 84 Median and Below (87%)

Above Median

Age 85 and older

Medicare Overview

http://www.census.gov/popest/archives/1990s/co-99-13/cacamars.txt

http://www.census.gov/popest/datasets.html


Beneficiaries with Disabilities California, 1999 to 2004

The number of Medicare

beneficiaries with

disabilities has grown

steadily over the past

five years.

Source: Table 83B, Hospital Insurance and/or Supplementary Medical Insurance: Number of disabled enrollees, by census division and state or other area, July 1, 1980–2004, selected years (in thousands), 2003 Annual Statistical Supplement, 2005 (www.ssa.gov/policy/docs/statcomps/supplement/2003/index.html, www.ssa.gov/policy/docs/statcomps/supplement/2005/index.html).

200420032002200120001999

452,000 465,000481,000

500,000522,000

550,000

Medicare Overview

http://www.ssa.gov/policy/docs/statcomps/supplement/2003/index.html



Beneficiary Income Distribution California, 2002

Most Medicare

beneficiaries rely on

relatively modest means.

Note: ESRD beneficiaries are excluded unless also eligible by aged or disabled status.


Medicare Overview

$125,000 and over

$100,000 to 124,999

$75,000 to 99,999

$65,000 to 74,999

$55,000 to 64,999

$45,000 to 54,999

$35,000 to 44,999

$25,000 to 34,999

$15,000 to 24,999

$5,000 to 14,999

Under $5,000 3%

29%

23%

14%

11%

7%

4%

3%

3%

2%

1%

ElderlyDisabled


Median Income of Beneficiaries by Age, California, 2002

Disabled beneficiaries have

the lowest median income.

Out-of-pocket costs for

health care can consume

a significant percentage

of that income.

Note: Excludes institutionalized beneficiaries and ESRD beneficiaries unless also eligible by aged or disabled status.

Source: 2002 Medicare Current Beneficiary Survey

85 and Older75 to 8465 to 74Under 65(Disabled)

$28,000

$20,400

$16,000

$18,000

Medicare Overview


Overall Medicare Spending United States, 1967– 2004

Source: Data from the Congressional Budget Office. Historical Budget Data. Appendix F of “The Budget and Economic Outlook: Fiscal Years 2006 to 2015.” Released January 25, 2005. Data from Tables 9 and 10: Outlays for Mandatory Spending.

Over the last four decades,

Medicare spending has risen

sharply across the nation,

both in total dollars and as

a percentage of GDP.

as Percent of GDP

0.0%

0.5%

1.0%

1.5%

2.0%

2.5%

3.0%

3.5%

20042000 1996 1992 1988 1984 1980 1976 1972 1968

in Billions

$0

$50

$100

$150

$200

$250

$300

$350

20042000 1996 1992 1988 1984 1980 1976 1972 1968

Medicare Utilization and Spending


Spending Per Medicare Beneficiary California and Selected States, 2001

Annual spending per

beneficiary in California is

the eighth highest in the

nation, more than $700

higher than the national

average. A great deal of

variation exists in Medicare

spending across the nation.

Contributing factors include

demographic differences,

medical practice, and price

variability.

Note: Denominator excludes beneficiaries enrolled in Medicare managed care.

Source: Centers for Medicare and Medicaid Services, CMS Health Care Financing Review Medicare and Medicaid Statistical Supplement, 2003, Table 15. Program Payments for Medicare Beneficiaries Residing in Urban and Rural Areas, by Area of Residence: Calendar Year 2001.

HawaiiColoradoU.S. AverageCaliforniaNew Jersey

$4,960

$4,020

$6,680

$5,940

$7,560



Both the unit cost and

utilization of hospitals

are rising for Medicare

beneficiaries in California.

Because inpatient care

is typically the most

expensive category of

treatment, this trend

has had a significant role

in overall Medicare

spending increases.

Hospital Utilization and Medicare Expenditures, California, 2000 to 2003

Source: Annual Statistical Supplement 2004: Medicare. Social Security Administration Table 8.B8a.

Average Medicare Expenditure per Day of Care

$0

$1,000

$2,000

$3,000

$4,000

$5,000

$6,000

$7,000

$8,000

$9,000

2003200220012000

Number of Discharges

700,000

725,000

750,000

775,000

800,000

825,000

850,000

875,000

900,000



The disabled population and

the very old have the highest

overall medical expenditures

and account for the most

Medicare spending.

Average Medical Spending Among Beneficiaries, by Source and Age, California, 2002

Note: Data excludes beneficiaries enrolled in Medicare managed care and all beneficiaries in nursing homes.

Source: 2002 Medicare Current Beneficiary Survey

75 and Older65 to 74Disabled (Under 65)

Out of PocketOther

Private InsuranceMedicaid Medicare

$14,877$828

$1,571

$2,741

$2,568

$7,169

$8,666$596

$1,745

$1,306

$546

$4,473

$13,258$436

$1,544

$1,868

$764

$8,646



Annual out-of-pocket spend-

ing for prescription drugs

averages just under $400,

with higher spending among

the disabled and older

elderly. These averages may

change as a result of the

implementation of the new

Medicare drug benefit.

Average Annual Out-of-Pocket Spending for Prescriptions by Age, California, 2002

Note: Data excludes nursing home residents and ESRD beneficiaries unless also eligible by aged or disabled status.


75 and Over65 to 74Under 65(Disabled)

$454

$305

$431



Few of California’s Medicare

enrollees age 65 and older

rely exclusively only on

traditional Medicare for

health insurance. More

than half rely on Medi-Cal,

Medigap, or employer-

sponsored insurance to help

cover health care costs.

Elderly* Enrollee Health Coverage California, 2002

*Age 65 and older.

Note: This graph represents primary coverage sources; in some cases, enrollees may have an additional source of coverage.


Medicare and Employer-Sponsored26%

Medicare HMO Only27%

Medicare and Medi-Cal

22%

Medicare and Medigap

17%

Medicare Only

8%

Medicare Coverage


Under 65 Enrollee Health Coverage California, 2002

Medicare enrollees under 65

with disabilities have less

private coverage than do

the elderly. Nearly half of

these disabled beneficia-

ries rely on Medi-Cal and

Medicare.

Note: This graph represents primary coverage sources; in some cases, enrollees may have an additional source of coverage. For adults age 18 to 64, eligibility for Medicare is tied to qualification for Social Security Disability Insurance.


Medicare and Employer-Sponsored17%

Medicare HMO Only14%

Medicare and Medi-Cal47%

Medicare and Medigap<1%

Medicare Only22%

Medicare Coverage


California has much

higher rates of Medicare

managed care enrollment

than the nation. As of

June 2004, California

had the fourth highest

enrollment in Medicare

HMOs in the nation

(not shown).

Medicare HMO Enrollment California vs. the U.S., 1989 to 2004

Source: Data for Nation and for California 1989 through 1996 taken from Kaiser Family Foundation California Healthcare Chartbook (www.kff.org/statepolicy/7086/sec5.cfm); 1997 to 2005 California data gathered from CMS Medicare Managed Care Contract (MMCC) Plans Monthly Summary Reports from the relevant years. Taken from the March quarter report in each year except for 1997 (June). Available online at www.cms.hhs.gov/healthplans/statistics/mpsct/.

California

U.S.

0%

5%

10%

15%

20%

25%

30%

35%

40%

2004200220001998 19961994 1992 1990

Beneficiaries in an HMO

Medicare Coverage

Source: Centers for Medicare and Medicaid Services: Market Penetration — Quarterly State/County Data File, June 2004. Cited in: “Health Care Financing Review: Medicare and Medi-Cal Statistical Supplement, 2003.” Centers for Medicare and Medi-Cal.

http://www.kff.org/statepolicy/7086/sec5.cfm

http://www.cms.hhs.gov/healthplans/statistics/mpsct/


Elderly and Medicare Advantage Plans Density and Number by County

The majority of Medicare

Advantage plans are in

densely populated areas.

Since the implementation of

the Medicare Modernization

Act, which introduced new

Medicare plan types, at

least two plans are available

in every county.

Sources: Density of elderly in the state from the 2000 Census. Number of Medicare Advantage Plans by County from CMS, 2005.

0–56–1920+

Senior Population Per Square Mile

2– 45–1415–2425–38

Medicare Advantage Plans

Medicare Coverage


Rates of self-reported

prescription drug coverage

tend to be higher in

Southern California and

lower in the more rural

areas of Northern California.

Elderly Prescription Drug Coverage by County, 2003

Note: In response to the question asked of all insured, 65 and older, “Are you covered for your prescription drugs? That is, does some plan pay any part of the cost?”

Source: 2003 California Health Interview Survey.

60 to 69%70 to 79%80 to 89%90 to 100%

Medicare Coverage


Prescription Coverage Source by Beneficiary’s Income, California, 2001

Historically, lower-income

beneficiaries have relied

largely on Medi-Cal for

prescription coverage; other

beneficiaries have received

coverage from employer-

sponsored coverage,

Medigap plans, HMOs, and

other private sources. The

implementation of the new

Medicare drug benefit on

January 1, 2006, will cause

this to change.

Note: The 2001 Federal Poverty Level (FPL) for an individual was $8,590 with $3,020 added for each additional person in the household. Federal Register, Vol. 66, No. 33, February 16, 2001: 10695–10697. Does not include disabled beneficiaries or those with end-stage renal disease only.

Source: Kaiser/Commonwealth/Tufts-New England Medical Center 2001 Survey of Seniors in Eight States. Cited in “California Seniors and Prescription Drugs.” Kaiser Family Foundation and Tufts-New England Medical Center. November 2002.

Over 200% FPL101 to 200% FPLUp to 100% FPL

21%

54%

24%

17%

82%

1%

16%

28%

56%

NonePrivateMedi-Cal

Medicare Coverage


Race/Ethnicity of Elderly Beneficiaries California vs. the U.S., 2000

California’s elderly Medicare

population is more diverse

than that of the nation.

Latino, Asian, and African

American beneficiaries make

up almost a third of the

state’s Medicare population.

Note: “Other” includes Pacific Islanders, American Indians, and multiracial.

Source: Census 2000 Summary File 1 (SF 1) 100-Percent Data.

13%

7%

California U.S.

10%

5%2%

2%

1%

10%

70% 80%

LatinoCaucasian(non-Latino)

Asian African American(non-Latino)

Other

Medicare Demographics


Diversity of Elderly Medicare Population, California, 2000 and 2020

The diversity of the elderly

Medicare population in

California in 2020 will be

even greater than in the

current population. The

Latino population is

expected to have the

most significant increase

over the next 14 years.

Note: “Other” includes Pacific Islanders, American Indians, and multiracial.

Sources: 2000 data from Census 2000 Summary File 1 (SF1) 100-Percent Data and 2020 data from RAND analysis of Department of Finance projections.

13%

22%

2000 2020

10%

5%

2%

15%

6%

3%

70%

54%

LatinoCaucasian(non-Latino)

Asian African American(non-Latino)

Other



Language Spoken in the Home by Age, California, 2003

Future Medicare

beneficiaries are more likely

to speak a non-English

language in the home.

This suggests a need for

Medicare resources in

multiple languages.

*Predominantly Chinese, Vietnamese, Korean. Note: Estimates for both languages may be low because the category “other” in the survey may include combinations of languages. Data include the non-Medicare population. Insurance status not included in data.


85 and Older75 to 8465 to 7445 to 64Under 44

Asian* Spanish

9%8% 8%

5%6%

8%

16%

12%

21%

35%



Age and Gender of Beneficiaries California, 2002

Except among those

beneficiaries with

disabilities, Medicare

enrollees in California

are overwhelmingly

female due to general

population trends and

longer life expectancy.


85 and Older75 to 8465 to 74Under 65(Disabled)

Male Female

42%

58%

44%

56%

41%

29%

71%

59%



Number of Chronic Conditions among Beneficiaries, California, 2002

Almost two-thirds of elderly

and disabled beneficiaries

have two or more chronic

health conditions.

Note: The definition of chronic condition used here is reported hypertension, cancer, diabetes, heart disease, lung disease, stroke, arthritis or Alzheimer’s disease. An individual qualifies for disabled status based on health status in addition to the ability to work in one’s profession and many other factors. Beneficiaries do not include those with end-stage renal disease only.


Elderly Disabled

One25%

Two27%

None12%

Three or more36%

One14%

Two27%

None25%

Three or more34%

Medicare Health Status


Many Medicare

beneficiaries have

an array of chronic

illnesses; the prevalence

of conditions varies by

beneficiary category.

Chronic Conditions of Beneficiaries by Eligibility Category, California, 2003

Note: Excludes ESRD-only beneficiaries. ESRD beneficiaries who also qualify as disabled or aged are included in that category.


StrokeObesityLungDisease

High BloodPressure

HeartDisease

DiabetesCancerAlzheimer’sDisease

Elderly Disabled

5% 0%

18%15%

17%

27%

36%

32%

55%

60%

14%

19% 18%

27%

9%11%



The prevalence of chronic

conditions varies by race

and ethnicity. Heart disease

and high blood pressure are

the most prominent across

all groups.

Chronic Conditions of All Beneficiaries by Race/Ethnicity, California, 2002

Notes: “Other” includes Pacific Islanders, American Indian/Alaskan Native and persons of multiple races/ethnicities.

Sources: 2002 Medicare Current Beneficiary Survey.

0%

5%

10%

15%

20%

25%

30%

35%

40%

45%

50%

55%

60%

65%

70%

75%

StrokeObesityLungDisease

High BloodPressure

HeartDisease

DiabetesCancerAlzheimer’sDisease

LatinoCaucasian (non-Latino) Asian African American (non-Latino) Other



Disabled beneficiaries and

the very old are the most

likely to be living in a

nursing facility.

Beneficiaries in Nursing Homes California, 2002


85 and Older65 and OlderDisabled(Under 65)

All Beneficiaries

11%

14%

5%

4%



Quality of Care by Medicare SpendingCalifornia vs. Other States, 2001

The quality of care for

California’s Medicare

beneficiaries is among the

worst in the nation, despite

the fact that Medicare

spending in California is

$700 more per beneficiary

than the national average.

Of all 50 states, California

is among the worst for

high spending and low

quality of care.$3,000 $4,000 $5,000 $6,000 $7,000 $8,000 $9,0001

6

11

16

21

26

31

36

41

46

51

Overall Quality Ranking

CA

Medicare Spending per Beneficiary

Best Higher QualityLower Spending

WorstLower Quality

Higher Spending

Notes: Quality ranking is created through use of twenty-two Medicare Quality Improvement Organization quality indicators abstracted from state-wide random samples of medical records for inpatient fee-for-service care and from Medicare beneficiary surveys or Medicare claims for outpatient care (Jencks 2003). The spending per beneficiary data presented here diverges from the data shown in earlier information in this presentation because the data used by Baicker and Chandra is limited to FFS beneficiaries and is also three years older.

Source: 1999 Medicare claims data and S.F. Jencks et al, “Change in the Quality of Care Delivered to Medicare Beneficiaries, 1998 – 1999 and 2000 – 2001.” Journal of the American Medical Association. 2003. Vol. 239, No. 3: 305–312.” Cited in Baicker, Katherine and Amitabh Chandra. “Medicare Spending, The Physician Workforce, And Beneficiaries’ Quality of Care.” Health Affairs — Data Watch. Web Exclusive. April 7, 2004.

Medicare Quality


Beneficiaries in California

receive recommended care

for chronic conditions about

half the time. Quality of

care varies across chronic

illnesses, from 41 percent

for diabetes to 63 percent

for high blood pressure.

Beneficiaries Who Received Recommended Care Orange County, California, 2001

Hypertension(High Blood Pressure)

Depression

Heart Disease

Pulmonary Disease

Diabetes

All Chronic Conditions 52%

41%

45%

52%

56%

63%

Note: This data is limited to Orange County, California. Data in geographic areas tend to be very similar however, and so this is likely reflective of California, and particularly of the Southern California region. Recommended care is defined through 439 quality indicators developed by RAND staff and validated by four multi-specialty expert panels, using the RAND/UCLA modified Delphi method.

Source: Community Tracking Survey and Telephone Surveys. Eve A. Kerr, Elizabeth A. McGlynn, John Adams, Joan Keesey and Steven M. Asch. “Profiling The Quality Of Care In Twelve Communities: Results From The CQI Study” Used with Permission from the authors. Health Affairs, Vol. 23, No. 3: 247–256.

Medicare Quality


Preventive Care for Beneficiaries by Income, California, 2003

The poorest Medicare

beneficiaries receive

fewer recommended

preventive care services.

This income disparity

is least apparent in the

number of beneficiaries

who received a flu shot

in the previous year.

Note: The 2003 Federal Poverty Level (FPL) for an individual was $8,980 with $3,140 added for each additional person in the household. Federal Register, Vol. 68, No. 26, February 7, 2003: 6456 – 6458. PSA is a screening test for prostrate cancer.


Ever had a PSA test?

Had mammogram in past two years?

Flu shot in last 12 months?

Ever had a Pneumonia shot?

Had a colonoscopy in the last five years?

0–99% FPL100–199% FPL200%+ FPL

47%

51%

65%

47%

60%

66%

68%

72%

74%

75%

74%

82%

70%

77%

90%

Medicare Quality


Medicare Appendix

Source: Calculated from both the 1990 and 2000 Census data. The 1990 data is available in archived population estimates (www.census.gov/popest/archives/1990s/co-99-13/cacamars.txt). The 2004 data is a projection from the 2000 Census in the file “County estimates by demographic characteristics — age, sex, race, and Hispanic Origin: Selected Age Groups and Sex.”

Elderly Population Growth by County, 1990 to 2004 Total 65 85 County Population and Older and Older

Alameda 12% 11% 58%Alpine 7% 70% 140%Amador 26% 28% 96%Butte 17% 2% 91%Calaveras 44% 45% 151%Colusa 25% 14% 88%Contra Costa 26% 31% 105%Del Norte 21% 18% 134%El Dorado 37% 37% 148%Fresno 30% 22% 71%Glenn 11% 0% 48%Humboldt 8% 10% 78%Imperial 39% 43% 110%Inyo 0% 0% 35%Kern 35% 26% 96%Kings 40% 33% 99%Lake 27% – 6% 86%Lassen 26% 9% 74%Los Angeles 12% 16% 56%Madera 58% 38% 91%Marin 7% 25% 90%Mariposa 26% 25% 124%Mendocino 10% 11% 84%Merced 33% 29% 91%Modoc – 1% 7% 33%Mono 28% 71% 94%Monterey 17% 18% 69%Napa 19% 4% 48%Nevada 24% 17% 107%

Total 65 85 County Population and Older and Older

Orange 24% 41% 79%Placer 78% 106% 182%Plumas 8% 17% 105%Riverside 60% 42% 137%Sacramento 27% 32% 102%San Benito 53% 29% 74%San Bernardino 35% 27% 74%San Diego 17% 20% 85%San Francisco 3% 4% 39%San Joaquin 35% 19% 76%San Luis Obispo 17% 19% 95%San Mateo 8% 13% 77%Santa Barbara 9% 13% 59%Santa Clara 13% 34% 74%Santa Cruz 9% – 3% 37%Shasta 21% 29% 121%Sierra 5% – 1% 94%Siskiyou 3% 15% 86%Solano 22% 51% 146%Sonoma 21% 13% 87%Stanislaus 35% 24% 78%Sutter 35% 41% 116%Tehama 21% 11% 66%Trinity 5% 25% 97%Tulare 29% 11% 65%Tuolumne 18% 31% 135%Ventura 19% 35% 103%Yolo 31% 29% 75%Yuba 11% 6% 67%

Almost all of California’s

counties experienced

significant growth in their

elderly population; growth

was most pronounced in

the 85 and older population.

http://www.census.gov/popest/archives/1990s/co-99-13/cacamars.txt


ResourcesMedicare Appendix

Annual Statistical Supplement, Office of Data Policy, Social Security Administration www.ssa.gov/policy/docs/statcomps/supplement/2004/index.html

California Health Care Chartbook, Kaiser Family Foundation, June 2004 www.kff.org/statepolicy/7086/index.cfm

California Health Interview Survey www.chis.ucla.edu

Centers for Medicare and Medicaid Services, Medicare Enrollment Data www.cms.hhs.gov/MedicareEnrpts

Congressional Budget Office, Historical Budget Data www.cbo.gov/budget/historical.pdf

Health Care Financing Review www.cms.hhs.gov/HealthCareFinancingReview

Medicare Current Beneficiary Survey www.cms.hhs.gov/MCBS

Medicare Web site provides information on how the program functions in California www.calmedicare.org

AuthorsCynthia R. Schuster, M.P.P.

Dana P. Goldman, Ph.D.

Mary Vaiana, Ph.D.

RAND Corporation

FOR MORE INFORMATION

California HealthCare Foundation

476 9th Street

Oakland, CA 94607

510.238.1040

www.chcf.org

RAND Corporation

1776 Main Street

Santa Monica, CA 90401

310.393.0411

www.rand.org

Click to complete our survey at www.chcf.org/feedback and enter Report Code #1040. Thank you.

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http://www.kff.org/statepolicy/7086/index.cfm

http://www.chis.ucla.edu

http://www.chis.ucla.edu

http://www.cms.hhs.gov/MedicareEnrpts

http://www.cms.hhs.gov/MedicareEnrpts

http://www.cbo.gov/budget/historical.pdf

http://www.cms.hhs.gov/HealthCareFinancingReview

http://www.cms.hhs.gov/MCBS

http://www.calmedicare.org

http://www.chcf.org

http://www.rand.org

http://www.chcf.org/feedback

medicare facts and figures: a california perspective€¦ · enrollment in medicare california and...

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